May 25, 2008: A 12-year-old girl is home alone with her 15-year-old brother when he starts acting strangely.
He tells her to come down to his room and close her eyes.
When she opens her eyes, he’s holding a plastic shopping bag. She tries to leave, but he crosses his arms around her neck and starts to squeeze.
She screams for him to stop. At one point, she tries to fake unconsciousness, but it doesn’t stop him.
Finally, she grabs an aluminum bat leaning against his desk and swings it behind herself until he lets go. She escapes and calls the police.
Concerned he could hurt himself or someone else, police take the boy into custody on an emergency mental detention.
Officers take him to the hospital for a medical exam, a requirement for admission to mental health treatment.
An officer sits with him for four hours until he gets medical clearance and can be admitted for mental health treatment.
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Police don’t want to leave a dangerous or unstable person alone in a hospital waiting room.
Nor do they want to leave streets unpatrolled.
But they don’t have much choice.
Police in Rock County are spending hours—sometimes as many as eight hours—sitting in hospital waiting rooms until people in custody on involuntary mental detentions get a medical check so they can be admitted for mental health treatment.
That pulls police off patrol, and it makes for a long night for the person in crisis, Janesville police officer Aaron Ellis said.
“It’s uncomfortable. Not just for us, but for the patient,” Ellis said.
State statutes require police to stay with involuntarily detained people until they are accepted by a receiving facility, Rock County Corporation Counsel Jeff Kuglitsch said. The emergency room at Mercy is not a psychiatric treatment facility, so officers are required to stay, Kuglitsch said.
It’s not Rock County’s idea to have police and people in crisis sit in the emergency room. Receiving facilities such as Mendota or Winnebago mental health institutes require patients to be checked over by a medical doctor before they can walk in the door.
Mendota and Winnebago are not medical hospitals, and they want assurance that a patient is not having a medical crisis on top of a mental health one, Rock County Human Services Director Charmian Klyve said.
That leaves people with a mental health emergency waiting for two ... four ... even up to eight hours for medical clearance before they can begin getting the treatment they need.
And in Rock County, it means a cop is waiting with them.
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June 11, 2008: A 17-year-old girl threatens to kill herself with a butcher knife. Her mother’s boyfriend gets cut on the hand when he tries to disarm her.
The girl has a history of anger management and attention deficit hyperactivity disorder. The previous week she had been taken to the hospital after overdosing on the painkiller Vicodin.
Officers take her into custody on an emergency mental detention and drive her to Mercy Hospital for medical clearance.
Two hours later, an officer still is in the waiting room with the girl and her mother. It’s shift change time, and another officer comes in for relief.
Sitting with police in the waiting room is embarrassing for the girl and her family, the girl’s mother tells the officer.
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It’s been an ongoing issue since Rock County closed its inpatient psychiatric facility in June 2002: Who’s responsible for people on emergency mental detention as they move through the channels to treatment?
The job has fallen to police who often are the first responders. Officers drive people to the hospital and wait with them. Behind the scenes, Rock County Crisis Intervention gets the ball rolling to determine if the person needs long-term care, outpatient treatment or neither.
Normally after the hospital visit, officers take people back to crisis intervention where they can be evaluated fully.
The long waits are not a problem with any particular hospital; it happens around the county, Evansville Police Lt. Art Phillips said.
He understands emergency personnel first need to treat patients who come in bleeding or having a heart attack as opposed to someone who’s not physically injured, Phillips said.
The problem, Ellis said, is having an officer sitting in the waiting room means one less body in a squad car.
“The time and the resources alone are a burden to any police department, no matter how many officers you have,” Ellis said.
In Evansville, an emergency mental detention could mean no officers are left to patrol, Phillips said.
He’s fed up.
“Why is it the responsibility of the police to stay at the hospital?” Phillips said. “I don’t understand why we have to remain there when we have nothing to do with it.”
Even if the patient is admitted into the psychiatric ward at Mercy, her or she first would need medical clearance from Mercy doctors, Klyve said.
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October 21, 2007: A drunken man punches out three windows at a business on Locust Street in Janesville. When police arrive, they decide he’s not suicidal or dangerous, but he is drunk and needs to go to detox.
But before he can be admitted to a facility in Madison, he needs medical clearance. In the emergency waiting room, the man gets mad about the wait. He is combative and accuses officers of framing him.
After 90 minutes, emergency room workers put a Band-Aid on the man’s hand.
Now he’s cleared to go.
Because the man is combative, he can’t ride with the civilian security company contracted to drive patients. A Rock County sheriff’s deputy must be pulled off patrol to drive him to Madison.
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A subcommittee of the Rock County Criminal Justice Coordinating Council has tackled the issue of long wait times for medical clearance. The subcommittee includes mental health advocates and representatives of law enforcement, Rock County Court and the district attorney’s office.
Rich Gruber, a Mercy Health Systems vice president, has been brought into the committee’s conversation. It’s a debate Gruber says has been going on for five years.
Mercy cannot assume responsibility of people in crisis because Mercy’s security company has a “hands off” approach, Gruber has said.
Crisis intervention can’t come to the emergency room and take over, either, Klyve said.
“What do we do with him if he decides he’s going to walk?” Klyve said. “We have no police powers. We have also no personal knowledge of anything that happened out at the scene (when police got involved), so we’ve got no basis to hold the person.”
Gruber has said Mercy will work internally to make sure mental health professionals can arrive quickly to the emergency room to help with medical clearance.
But he has said that the real responsibility lies with the county to take care of its own.
Situations taken from Janesville Police Department records.
WHAT IS EMERGENCY DETENTION?
Emergency detentions, including holds under state statute 51.15 or 51.45, work like an arrest but are not criminal, said Eugene Dumas with the Rock County Corporation Counsel’s Office.
Officers place an intoxicated person or a person going through a mental health crisis into protective custody so they don’t hurt themselves or others.
Under state statutes, this starts a series of court appearances to balance a person’s personal liberty and their need for treatment and protection, Dumas said.
A detention under chapter 51 of state statutes is not a criminal charge, Dumas said. In some cases, people who have criminal charges against them and move through those proceedings as well, Dumas said.